[pct-l] Plantar Fascitis

[Richard Woods]

Thank you all for your input. Extremely valuable.

To recap, I trashed both feet last year on the trail, and have tried  
all of the conservative treatments over the past year including  
cortisone shots, ultrasound, PT and walking casts, yadayada. My right  
foot feels more or less normal now, but the left has not responded.  
Dull aching pain in the left heel, worse in the morning or after  
sitting, exacerbated by walking/standing for long periods of time.  
Plantar Fasciitis, but I'm in the 1% who don't seem to respond to the  
standard therapies.

Here's feedback from the orthopedic specialist I visited yesterday:  
Greg Lundeen, M.D. Orthopedic Surgeon, specializing in disorders of  
the foot and ankle, and practicing at least part of the time out of  
the University of Nevada, Reno Sports Medicine Center.

He considers my plantar fasciitis to be a symptom of an underlying  
disorder. I've had weak ankles all my life, especially my left. He  
thinks that every time I roll an ankle, I start walking a bit  
differently to compensate. Favoring the ankle puts abnormal stress on  
the PF, and sooner or later I have a flare-up. Bingo.

Rooting around in my memory of that 65-miler last year, I do remember  
rolling my left ankle early in the trip, somewhere around Meiss  
Meadow. Intense pain passed, with no bruising this time, but it  
remained tender. Northbound on the PCT, around Granite Chief I  
finally admitted my feet were not doing well at all. So I called it  
quits and bailed in Tahoe City.

My left ankle in particular is a three-time loser. I've had casts on  
it from really bad sprains, and it's so weak that I choose boots with  
high tops to support it.

My left foot is not responding to therapy to date, and he thinks that  
I've not been stretching enough, and that I need some serious rehab  
work on my ankle strength.

So in the next six weeks, I'm directed to:
- stretch my ankles and hamstrings for long, slow periods, not short  
get-it-done-with bursts. Before getting out of bed in the morning,  
loop a towel around each toe and pull back for two minutes, each  
foot. He says this is just as effective as wearing a night splint,  
which most people can't maintain anyway. True. I've not been able to  
keep one on all night, without drugs to keep me asleep.
- Stand on one foot, toes on the edge of a step and allow my weight  
to push the heel down, while my toes flex up toward my knee, hold for  
five minutes per foot. (seems like five hours!)
- practice balancing on one foot, until I can do it for minutes at a  
time, eyes closed, on something soft like a pillow. Repeat for other  
foot. Purpose is to get my brain and ankle talking to one another,  
while strengthening my ankle. This is a lot harder than it sounds.
- Use elastic bands for resistance training against rotation of my  
toes outward from the heels. Start with easy amount of resistance/low  
reps and work up to heavy/more reps.